Joel L Cohen1, Jane Thomas, Deepali Paradkar, Adam Rotunda, Patricia S Walker, Frederick C Beddingfield, Asha Philip, Paula G Davis, Ramana Yalamanchili. 1. *Director, AboutSkin Dermatology and DermSurgery, Englewood, Colorado; †Allergan, Inc., Santa Barbara, California; ‡Assistant Clinical Professor of Medicine/Dermatology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; §Private Practice, Newport Beach, California; ‖Private Practice, Santa Barbara, California; ¶Allergan, Inc., Irvine, California; #SCI Scientific Communications and Information. J.T. and F.C.B. are in Kythera Biopharmaceuticals, Calabasas, California. P.S.W. Kythera Biopharmaceuticals, Agoura Hills, California.
Abstract
BACKGROUND: Validated aesthetic rating scales for the perioral area provide objective evaluations for clinical trials and practice. OBJECTIVE: To confirm the reliability of 3 scales for evaluating dermal filler and neurotoxin treatments of the perioral area. MATERIALS AND METHODS: Three lip-specific photographic scales were developed from standardized 2-dimensional images to evaluate Perioral Lines at Rest (POL), Oral Commissures (OCS), and Perioral Lines at Maximum Contraction (POLM) severity scales. Each 4-grade scale (none to severe) had 3 representative images per grade. Physician validators rated volunteers on each scale (2 rounds of live review). Volunteers provided 2 series of self-assessments. Physician and subject intrarater reliability were based on the comparison of round 1 and round 2 scores (mean weighted kappa coefficient). Other measures were physician interrater agreement (intraclass correlation) and subject/physician interrater agreement (Pearson correlation). RESULTS: Physician intrarater agreement was almost perfect or substantial (POL, 0.725; OCS, 0.789; POLM, 0.826). Overall, physician interrater agreement was almost perfect for all 3 scales and ranged from moderate to substantial by grade. Subject intrarater agreement and subject/physician interrater agreement were substantial. CONCLUSION: All scales demonstrated a high degree of intrarater and interrater reliability during the validation process. Physician concordance was good; subject ratings were reliable and comparable to physician assessments.
BACKGROUND: Validated aesthetic rating scales for the perioral area provide objective evaluations for clinical trials and practice. OBJECTIVE: To confirm the reliability of 3 scales for evaluating dermal filler and neurotoxin treatments of the perioral area. MATERIALS AND METHODS: Three lip-specific photographic scales were developed from standardized 2-dimensional images to evaluate Perioral Lines at Rest (POL), Oral Commissures (OCS), and Perioral Lines at Maximum Contraction (POLM) severity scales. Each 4-grade scale (none to severe) had 3 representative images per grade. Physician validators rated volunteers on each scale (2 rounds of live review). Volunteers provided 2 series of self-assessments. Physician and subject intrarater reliability were based on the comparison of round 1 and round 2 scores (mean weighted kappa coefficient). Other measures were physician interrater agreement (intraclass correlation) and subject/physician interrater agreement (Pearson correlation). RESULTS: Physician intrarater agreement was almost perfect or substantial (POL, 0.725; OCS, 0.789; POLM, 0.826). Overall, physician interrater agreement was almost perfect for all 3 scales and ranged from moderate to substantial by grade. Subject intrarater agreement and subject/physician interrater agreement were substantial. CONCLUSION: All scales demonstrated a high degree of intrarater and interrater reliability during the validation process. Physician concordance was good; subject ratings were reliable and comparable to physician assessments.
Authors: Alexander Rivkin; Susan H Weinkle; Bhushan Hardas; Robert A Weiss; Dee Anna Glaser; Brian S Biesman; Andrew Schumacher; Diane K Murphy Journal: Aesthet Surg J Date: 2019-03-14 Impact factor: 4.283
Authors: Nestor Demosthenous; David Eccleston; Vitor Figueiredo; Luis Uva; Graeme Kerson; Michael Silberberg Journal: Aesthet Surg J Open Forum Date: 2022-05-15
Authors: Jean Carruthers; Lisa Donofrio; Bhushan Hardas; Diane K Murphy; Derek Jones; Alastair Carruthers; Jonathan M Sykes; Lela Creutz; Ann Marx; Sara Dill Journal: Dermatol Surg Date: 2016-10 Impact factor: 3.398